Simply stated, hypertension is the condition where you have chronically and abnormally high arterial blood pressure (BP). The commonest type of hypertension, seen in 95% of cases, is Essential hypertension also called Primary or Idiopathic hypertension. Essential hypertension does not have any identifiable reason. The remaining 5% cases are classed as secondary hypertension and would have an underlying medical cause like diabetes, age related reason, pregnancy or various other diseases like heart disease.

Hypertension affects about a billion people worldwide and is a major risk factor for cardiovascular disease. As the condition may have no symptoms and the person feels absolutely normal, it is usually detected accidentally. Hypertension is a serious condition and can do a lot of harm to the body. Regular BP checkups are recommended for all, especially as we grow older.

The Normal BP in an adult human is 120 mmHg systolic and 80 mmHg diastolic, written up as 120/80.
A high normal (prehypertension) BP would range from 120-139 mmHg systolic and 80-89 mmHg diastolic;
Stage 1 hypertension would range from 140-159 mmHg systolic and 90-99 mmHg diastolic;
Stage 2 hypertension would range from 160-179 mmHg systolic and 100-109 mmHg diastolic and
Stage 3 hypertension would be above 180 mmHg systolic and above 110 mmHg diastolic.

To be classified as hypertension, one should show persistent high BP over more than one measurement. Once identified as being hypertensive, investigations to check for organ damage – heart, eye and kidneys – should be done while cerebrovascular damage may be seen in older patients.

The treatment for the condition is based on the hypertension stage and cardiovascular risk, plus any organ damage. For stage 1 and low cardiovascular risk, only lifestyle modification and medication plus lifestyle changes for others. The medication has to be continued life-long.

The lifestyle changes:

• Cease smoking,
• Limit salt to less than 6g/day, avoid adding salt to food and processed food with salt.
• Limit alcohol consumption per day to 24-32 g for men and 16-24 g for women.
• Maintain near to ideal body weight for your height
• Be Active. Aerobic exercises for at least 30 mins for a minimum 4 days a week like jogging, cycling, swimming or any active sports or even a brisk walk.

Personal and lifestyle choices contribute to the incidence of hypertension and if these are altered, can lead to return to normal condition.

Ayurveda and Hypertension

In Ayurveda, hypertension is an abnormality of Rakta Dhatu (blood) and is termed Shonita Dusti. As in modern medicine, the primary treatment especially in case of pre hypertension would be life style change – healthy food habits and yoga. There are many treatment options suited for individual conditions.

Internal Treatments done for Hypertension include Panchakarma or Ayurvedic cleansing (detoxification) treatments to cleanse the body; Virechana or therapeutic Purgation; Shirovirecana (purification through nasal root) and Vasti (Medicated Enemas) to correct the metabolism and lose excess weight.

External treatments include Dhara’s like Takra Shiro Dhara (using medicated buttermilk), Ksheera Dhara (using medicated milk) or Taila Dhara (using medicated oil). The Dhara (stream) is made to smoothly flow on the scalp and/or body of the patient lying on his back on a special wooden table. The dhara can last for a period of 35-45 minutes. Other forms like Shiro Pichu – keeping cotton pieces dipped in medicated oil on the scalp and tying it in place and Shiro Vasti – pooling of medicated oil in a cabin created on the head are also advised. These Dhara’s help in relieving one from stress, calms the nerves, improves circulation, relieves hypertension and insomnia, relaxes the person physically and mentally and re-establishes health.

Shiro Lepa is another effective treatment for hypertension where medicated pastes of herbs are applied on the scalp and Avagaha which is tub bath in medicated oil.

Herbs beneficial for Hypertension

The mechanism of action in controlling BP is either through reduction of stress hormone production or by lowering edema and inflammation in the body. Stress hormones damage the inner lining of the blood vessels while inflammation increases the resistance against blood flow against the vessel walls both of which lead to higher BP.

Many Ayurvedic herbs like Sarpagandha (in Rasagandha and Bramhi Vati), Ashwagandha, Arjuna, Gokshura, Triphala (a combination of three herbs – amla, haritaki and bibhitaki), Jatamansi and other regular food items like Garlic, Celery, Pomegranate, Wheat bran and Ginger are effective in controlling high BP, reduce hypertension and normalize blood circulation.

Yoga for Hypertension:

Yoga, at least initially, should be attempted under guidance if you are having any medical condition or if you are above 50. Starting out, yoga postures that do not invert the body are recommended for people with hypertension.

Calming restorative asanas like Savasana pose and focusing on the incoming and outgoing breath for about 10 minutes reduces stress and helps normalize BP naturally. Stretching poses like leg stretches and hip openers are also good. Poses that put the spine in a horizontal position allow the heart to slow down. Sitting and lying asanas like Baddhakonasana (Bound Angle or Cobbler Pose), Virasana (Hero Pose), and Upavista Konasana (seated angle pose) are recommended.

After practicing the above asanas for a few weeks, asanas with mild inversions can be tried. Setu Bandha Sarvangasana (Bridge Pose) or Adho Mukha Svanasana (Downward-Facing Dog) are postures that position the heart slightly above the head, causing slight increase to the pressure in the head.